Embedding oncology patient navigators within ePRO workflows to support patient engagement.
Abstract
444 Background: Electronic patient-reported outcome (ePRO) programs support remote symptom monitoring and timely clinical intervention in oncology, yet sustaining participation in non-research standard of care symptom monitoring remains challenging. Technology platforms alone may be insufficient to maintain engagement across complex treatment courses. Integrating Oncology Patient Navigators (OPNs) into ePRO workflows may address participation barriers and strengthen operational and relationship-based support for remote symptom monitoring programs. Methods: An electronic symptom monitoring (eSyM) program was implemented at a large, safety-net, academic cancer center using Epic-integrated ePRO workflows for patients receiving outpatient systemic therapy. OPNs were integrated as dedicated, non-licensed support personnel responsible for patient education, supporting ePRO participation as part of the patient’s care plan, outreach, troubleshooting, and monitoring survey completion. Their embedded presence in infusion and clinic settings enabled real-time engagement and reinforcement of weekly symptom reporting as part of routine care. OPNs collaborated with a dedicated ePRO triage nurse and oncology teams to identify barriers and refine workflows based on patient feedback. Results: The program achieved a 75% ever-completion rate (n=410). Patient engagement improved with phased OPN integration (Table). Two part-time OPNs were associated with the highest proportion of high-engagement participants (43.1%). Operational experience identified in-person “warm touch” interactions as an important component of the engagement workflow. Patient feedback informed iterative workflow refinement to improve experience and support program sustainability. Conclusions: Integrating OPNs within oncology ePRO workflows may improve patient engagement and strengthen implementation of remote symptom monitoring programs. Relationship-based, embedded engagement strategies represent a potentially important operational component of scalable and sustainable oncology digital health models. Engagement rates across OPN support levels. OPN Support Overall Engagement Low Engagement (0–39%) High Engagement (60–100%) No OPN 18% 86.4% 6.8% 1 Part-Time OPN 43% 57.0% 31.9% 2 Part-Time OPNs 53% 46.4% 43.1%